Re: A question for a friend

Her mother (age 81) is T2.
She fell and broke her hip and wrist several weeks ago, and she is now in
a rehab/nursing home.

As soon as she was transferred to the rehab/nursing center, she was
shifted from oral medication to insulin, and the nursing home does not
make any attempt to provide a suitable diet. Everyone gets the same
thing - a "one size fits all" approach in dietary management.

if very ill also non diabetic humans become hyper glycemic. This is a
reasonable defense mechanism of the body, because the immuun system has to
expand his repertoire and number of white blood cells. This system runs on
glucose .... :)

So (very) old and or (very) ill patients are supplied with ample amounts of
carbohydrate and thus they all get the same nutricious but high carb diet..
Also diabetic patients. The only difference being (of course) a strictly
monitored insulin regime.

Talk to your dokter if you have questions. Don't hesitate to ask for the
blood glucose log's if you suspect that your mother is not properly looked
after. But remember that also for a diabetic there are other priorities if
he is (very) old or ill . In this situation a higher blood glucose is a
better choise for survival.

Abstract
Hyperglycaemia is common during critical illness and may be viewed
teleologically as a means of ensuring an adequate supply of glucose for the
brain and phagocytic cells. Under normal conditions, euglycaemia is
maintained by neural, hormonal and hepatic autoregulatory mechanisms.
Critical illness promotes hyperglycaemia through an activation of the
hypothalamic-pituitary-adrenal axis, which in turn increases hepatic glucose
production and inhibits insulin-mediated glucose uptake to skeletal muscle.
Sustained hyperglycaemia is associated with adverse consequences that demand
its control. Appropriate management includes discontinuing causative drugs,
correcting hypokalaemia, treating infection and administering insulin.
Insulin therapy also appears to be useful for promoting an anabolic response
in skeletal muscle. Copyright 2001 Harcourt Publishers Ltd.